A 70-year-old woman was admitted to our hospital due to cardiogenic shock and died of heart failure 1 day after admission. She had a 12-year history of hemodialysis. Biodegradable-polymer biolimus-eluting stent (NOBORI, Terumo Corporation, Tokyo, Japan) was implanted in the left anterior descending artery 2 months before. An autopsy was performed, and ex vivo intravascular ultrasound (Terumo Corp.), optical frequency domain imaging (Terumo Corp.), and coronary angioscopy (FiberTech, Tokyo, Japan) were examined.

The target lesion calcification is an important determinant of the expansion of stent (2). A CN hardly expands by the tensile strength of stent deployment. In fact, the stent area was insufficient in the present case. Furthermore, a healthy vessel wall might be overstretched and rupture during the intervention. We need to exercise every precaution for an intervention of a CN.

Footnotes

The authors have reported that they have no relationships relevant to the contents of this paper to disclose.